Various surgical procedures are routinely carried out intravascularly or intraluminally. For example, in the treatment of vascular disease, such as arteriosclerosis, it is a common practice to access the artery and insert an instrument (e.g., a balloon or other type of catheter) to carry out a procedure within the artery. Such procedures usually involve the percutaneous puncture of the artery so that an insertion sheath can be placed in the artery and thereafter instruments (e.g., a catheter) can pass through the sheath and to an operative position within the artery. Intravascular and intraluminal procedures unavoidably present the problem of stopping the bleeding at the percutaneous puncture after the procedure has been completed and after the instruments (and any insertion sheaths used therewith) have been removed. Bleeding from puncture sites, particularly in the case of femoral arterial punctures, is typically stopped by utilizing vascular closure devices, such as those described in U.S. Pat. Nos. 6,090,130; 6,045,569; 7,597,705; 7,618,436, 7,749,248; 7,931,670; 7,837,705; and related patents and patent applications, all of which are hereby incorporated by reference.
Typical closure tools or devices such as the ones described in the above-mentioned patents place a sealing plug at the tissue puncture site. Successful deployment of the sealing plug requires that it be ejected from within a device sheath into the incision or puncture tract and tamped down to an outer surface of the tissue puncture using a tamping tube (also called a compaction tube). In an automatic tamping system, the closure tool can have an automatic tamping mechanism for automatically tamping the sealing plug within the incision or puncture tract toward the outer surface of the tissue puncture. The closure tool can have a tamping tube disposed adjacent to the sealing plug, such that the tamping tube is driven by the automatic tamping mechanism to tamp the sealing plug into the desired placement.
The automatic tamping mechanism can take up linear space, especially if the automatic tamping mechanism used to tamp the sealing plug is a linear rack. The linear rack can be stored in the handle, which can result in a long handle design, to accommodate the linear rack. Alternatively, the automatic tamping mechanism can be a coilable rack. Such a coilable rack can be coiled in the handle and, as the coilable rack approaches the tamping tube or compaction tube, the rack straightens and becomes linear. The coilable rack may not have the column strength that the linear rack may have. However, the ability of the rack to coil can result in a smaller, more compact handle. Nevertheless, there is a need for improving the automatic tamping mechanism, where the mechanism can provide the columnar tamping strength for disposing a sealing plug at the external wall of a puncture.